Left Ventricular Assist Device in a Patient With a Concomitant Subcutaneous Implantable Cardioverter Defibrillator

A 51-year-old male, with prior coronary artery bypass grafts and a more recent history of recurrent hospital admissions for refractory heart failure, presented with advanced heart failure caused by ischemic cardiomyopathy. The patient was placed on the heart transplantation list. A subcutaneous-implantable cardioverter/defibrillator (S-ICD; Cameron Health, San Clemente, CA) was electively implanted 1 month later for primary prevention. At implant, sustained ventricular fibrillation was induced and successfully converted to normal sinus rhythm with a submaximal 65 J standard polarity shock with time to therapy of 13 s and impedance of 55 Ω. After an uneventful postoperative period, the patient was discharged home but readmitted a few weeks later with …